Individual provider Active NPI

Elizabeth Stolz Kughn, MFT

  • Marriage & Family Therapist
  • San Rafael, CA
National Provider Identifier
1750466751
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
36942 Issued in CA
Practice address
1634 5TH Ave
San Rafael, CA 94901-1809
Phone
(415) 721-4555
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 36942 CA Primary

Addresses

Primary practice location

1634 5TH Ave
San Rafael, CA 94901-1809

Mailing address

1634 5TH Ave
San Rafael, CA 94901-1809
Phone (415) 721-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1750466751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 5TH AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011809",
            "telephone_number": "415-721-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 5TH AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011809",
            "telephone_number": "415-721-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUGHN",
        "first_name": "ELIZABETH",
        "middle_name": "STOLZ",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "36942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.